Linda Mamdoh a Albusoul, MD

Key facts

NPI: 1497326581
Entity type: Individual (NPI type 1)
Primary specialty: Student in an Organized Health Care Education/Training Program 390200000X
License: 4351048264 (MI)
Practice address: 2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2689
Phone: (313) 916-1888
Fax: (313) 916-1394
NPI assigned: Jul 8, 2021
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210907001776	MI	Order and Referring Only - Internal Medicine Practitioner - Internal Medicine	3375949944

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Interoperability endpoints

Direct secure messaging: lalbusoul725899@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X	4351048264	MI	Yes

Addresses

Primary practice location

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2689

Mailing address

2799 W Grand Blvd
Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2689
Phone (313) 916-1888

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2021.

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1497326581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-1888",
            "fax_number": "313-916-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-1888",
            "fax_number": "313-916-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALBUSOUL",
        "first_name": "LINDA",
        "middle_name": "MAMDOH A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351048264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

All providers in Detroit, MI · Student in an Organized Health Care Education/Training Program in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.